UB works to increase colorectal cancer screening among African-Americans

by jmaloni

Submitted

Wed, Oct 23rd 2013 07:00 am

More than $2 million awarded for UB to
collaborate on study of narrativeinterventions

More African-Americans
get colorectal cancer and die from it than any other ethnic or racial group.

While screening for the
disease, by colonoscopy in particular, is the most effective way to detect
colorectal cancer early and thereby improve treatment outcomes, studies show
there are substantial disparities for screening when comparing African-Americans
to other groups.

Compared to white
Americans, African-Americans are 20 percent more likely to get CRC and 18
percent more likely to die from it.

The University at
Buffalo, Roswell Park Cancer Institute and Icahn School of Medicine at Mount
Sinai are collaborators on a $2,658,940 grant from the National Cancer
Institute to study what influences African-Americans to get screened for CRC
and to develop interventions based on those influences.

"There is a critical
need to understand why so many African-Americans aren't getting screened for
CRC," said Marc Kiviniemi, Ph.D., assistant professor in the UB department of
community health and health behaviors, and one of several principal
investigators on the grant.

Kiviniemi said that
while most behavioral research has linked cognitive decision-making (perceived
benefits and barriers) and affective decision-making (fear and worry) to
predicting whether individuals will get CRC screening, little work has been
done on examining these dynamics among African-Americans.

"This creates
significant gaps in knowledge about the role of feelings in predicting and
potentially increasing CRC screening for minorities," he said.

Kiviniemi said most
educational material about CRC involves fact-based strategies for informing the
public about the importance of CRC screening, but this does not seem to be an
effective strategy for encouraging screening for African-Americans.

The goal of this study,
he said, is to use our understanding of how and why African-Americans are
influenced to participate in CRC screening and to develop narrative-based
educational strategies to encourage CRC screening in African-American
communities.

The study will examine
the impact of two randomized community interventions on cognitive and affective
factors and their resulting influence on health care seeking and CRC screening
behaviors for African-Americans.

Kiviniemi is an expert
on how individuals' health decision-making is influenced by feelings. He began
his research in 2004.

"At first I was just
observing and listening to people talk about their health behaviors and
noticing that there were situations where people knew that they 'should' do
something but didn't really want to - like exercising or getting a colonoscopy
- or other situations where they knew that they shouldn't do something but
liked doing it - like eating junk food," he said.

Most of the theories
that existed to explain people's health behaviors, Kiviniemi said, could
explain the "should do" or "shouldn't do" judgments people
were making, but couldn't account for the more visceral, emotional reactions
that lead people to do things like eat junk food or to not get a screening
test.

"For several years now,
my lab's work has focused on understanding how individuals' emotions affect
their choices about health," Kiviniemi said. "From a practical, health
promotion perspective, we address the question of how we can shift the
emotional associations people have with health behaviors to encourage them to
make healthier behavioral choices."

Kiviniemi's lab will
figure prominently into the study. It is set up for the work on study design
and data analysis.

His fellow principal
investigators on the grant are Deborah Erwin, Ph.D., Roswell Park Cancer
Institute, and Lina Jandorf, MA, of Icahn School of Medicine at Mount Sinai. Gary
Winkel, Ph.D., also of Icahn School of Medicine at Mount Sinai, is a
co-investigator.